Abstract
This essay discusses Susan Smiley’s documentary film, Out of the Shadow (2004), and Tina Kotulski’s memoir, Saving Millie: A Daughter’s Story of Surviving Her Mother’s Schizophrenia, as filmic and narrative treatments of their mother’s schizophrenia. Mildred Smiley, and her diagnosis of and treatment for schizophrenia, is at the center of both her daughters’ treatments of mental illness, and in these texts, all three become witnesses to the multiple experiences of mental illness and the multiple events of psychiatric power. As I will argue, these two texts are treatments of schizophrenia that both see and don’t see Mildred Smiley’s experience of mental illness. Through these texts, we—viewer and reader—are asked to look again, or to look for the first time, at mental illness, and we are positioned as having the agency to look or look away. As we look and try to make sense of what we see (and don’t see), we too participate in the production of mental illness as a category of analysis.
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Notes
Available from Vine Street Pictures, P.O. Box 662120, Los Angeles, CA 90066; information about purchasing at www.outoftheshadow.com.
In particular, I am influenced by the following key texts: S. Felman and D. Laub, Testimony: Crises of Witnessing in Literature, Psychoanalysis, and History (New York and London: Routledge, 1992); C. Caruth, ed. Trauma: Explorations in Memory (Baltimore: Johns Hopkins University Press, 1995); and K. Oliver, Witnessing: Beyond Recognition (Minneapolis: University of Minnesota Press, 2001). Much of the recent work in trauma theory utilizes Freud’s concept of the death drive as formulated in 1920 in Beyond the Pleasure Principle, trans. J. Strachey (New York and London: W.W. Norton, 1961).
T. Kotulski, Saving Millie: A Daughter’s Story of Surviving her Mother’s Schizophrenia (Madelia, Monnesota: Extraordinary Voices Press, 2006). Subsequent references to this work appear in the text.
In his essay “What is Enlightenment?” Foucault recommends a philosophical ethos that consists “in a critique of what we are saying, thinking, and doing, through a historical ontology of ourselves,” Ethics: Subectivity and Truth (Essential Works of Foucault 1954–1984, Vol. 1), trans. C. Porter (New York: The New Press, 1997), 315.
A genealogy of Foucault’s own extensive work on madness would have to include at least the following: Mental Illness and Psychology; trans. A. Sheridan (Berkley: University of California Press, 1987); Madness and Civilization: A History of Insanity in the Age of Reason, trans. R. Howard (New York: Vintage, 1965); The Archaeology of Knowledge and the Discourse on Language, trans. By A.M. Sheridan Smith (New York: Pantheon Books, 1972); and Psychiatric Power: Lectures at the Collège de France, 1973-74, ed. J. Lagrange, trans. G. Burchell (Houndmills: Palgrave Macmillan, 2006).
Foucault, Psychiatric Power, 161.
Ibid., 54.
At the end of Out of Shadow, describing her job at a fast food sandwich chain, Mildred tells Susan, “I love work. It’s normal people. The bus [she takes to get to work] is normal people. You’re normal people.”
When the film was shown on PBS in October 2006, it was reviewed in The New York Times, and the critical response could not have been more clichéd. Mildred Smiley is described as a “true heroine,” who “undergoes a transformation, metamorphosing from a minimally functioning mental patient into a loving grandmother. For all their tribulations, the Smileys have something to smile about.” S. Stewart, “A Mother in Shades of Gray, Love, Schizophrenia and All,” The New York Times (October 7, 2006), nytimes.com Accessed June 17, 2009.
This is, of course, precisely Foucault’s project and method in both Madness and Civilization and his lectures published as Psychiatric Power.
M. Swartz, “Foreword,” in T. Kotulski, Saving Millie: A Daughter’s Story of Surviving Her Mother’s Schizophrenia (Madelia, Monnesota: Extraordinary Voices Press, 006), xi.
For an account of the shift from the dominance of psychoanalytic to biological thought styles in psychiatry, see J. Metzl, Prozac on the Couch: Prescribing Gender in the Era of Wonder Drugs (Durham and London: Duke University Press, 2003), 7. For a compelling critique of the new biological psychiatry, see B. Lewis, Moving Beyond Prozac, DSM and the New Psychiatry: The Birth of Postpsychiatry (Ann Arbor: The University of Michigan Press, 2006).
Foucault, Madness and Civilization, 239.
For an historical account, and critique, of the practice of deinstitutionalization, see E. F. Torrey, Nowhere to Go: The Tragic Odyssey of the Homeless Mentally Ill (New York: Harper and Row, 1988) and Out of the Shadows: Confronting America’s Mental Illness Crisis (New York: John Wiley and Sons, 1997); G.N. Grob, From Asylum to Community: Mental Health Policy in Modern America (Princeton: Princeton University Press, 1991) and “Deinstitutionalization: The Illusion of Policy,” Journal of Policy History, 9 (1997), 48–73. In Out of the Shadows, Torrey argues that “[d]einstitutionalization began in 1955 with the widespread introduction of chlorpromazine, commonly known as Thorazine, the first antipsychotic medication, and received a major impetus 10 years later with the enactment of federal Medicaid and Medicare” (8). Torrey calls deinstitutionalization “one of the largest social experiments in American history” (8).
There is some confusion between Smiley’s film and Kotulski’s memoir as to when exactly Mildred Smiley is finally diagnosed with paranoid schizophrenia. In Out of the Shadow, Susan’s voiceover notes that Mildred is diagnosed after Tina is placed under the care of a psychiatrist after a suicide attempt in 1979, when she is in her early teens. In Saving Millie, Kotulski gives a much more detailed account of the relief she feels when Mildred’s condition is finally named paranoid schizophrenia in 1985.
Foucault, Madness and Civilization, 241.
In some ways, Smiley’s work exemplifies the three levels of witnessing that Dori Laub has identified in relation to the Holocaust experience: “the level of being a witness to oneself within the experience; the level of being a witness to the testimonies of others; and the level of being a witness to the process of witnessing itself,” “An Event Without a Witness: Truth, Testimony and Survival,” in S. Felman and D. Laub, Testimony: Crises of Witnessing in Literature, Psychoanalysis, and History,” 75.
In her review in The New York Times, Stewart critiques the film for its ineffective challenge to the public health system. “The villain of ‘Shadow’ is the vast and anonymous system that shuttles this woman from one psychiatrist to another without continuity of care or consistency in medication. Health care is an easy target, and ‘Shadow’ is stronger when it’s not tilting at institutional windmills.” If health care is such an easy target, then why is taking it on likened to “tilting at institutional windmills”?
Thanks to Victoria Hesford for pointing this out to me.
Foucault, Psychiatric Power, 236.
Ibid.
Foucault, Psychiatric Power, 237.
The first page of the record of Mildred Smiley’s stay at Hinsdale Sanitarium and Hospital from July 14, 1983 to July 19, 1983, when she was transferred to the Madden Zone Center, is shown at the beginning of Out of the Shadow, but, unless one stops the film and reads the text of the medical record, its specific contents remain difficult to discern. Other medical records are also shown in the film, which are scanned and have phrases and partial sentences highlighted for the viewer’s perusal, including, for example: “The patient was in total rage” and “homeless, was very paranoid.”
One of the curious things about Kotulski’s memoir is that in most of the instances in which Mildred is quoted, the quotes come from Smiley’s film. In a way this is another kind of witnessing—Kotulski extends Smiley’s witnessing in the film by incorporating elements of the film into her own text.
Except perhaps in one scene where Smiley and camera follow along as Millie goes to refill her many prescriptions at the pharmacy. In this scene, she seems uncomfortable, though it is hard to say whether the discomfort is with being filmed or with having to refill her prescriptions, or a combination of the two: being captured on film refilling prescriptions.
It is possible that Smiley has edited out footage in which Millie makes it apparent that she doesn’t want to be filmed, but, even if this were the case, I’m not sure it would call into question the impression that Mildred likes being in front of the camera. In a recent addition to the website for the film, Susan Smiley has added a note about the making of the film, which addresses directly the question of Mildred Smiley’s consent: “I would not, or could not have made the film without my mother’s unequivocal consent and support,” http://www.outoftheshadow.com/about_susan_family.html (accessed June 17, 2009).
References
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Stewart, S. “A Mother in Shades of Gray, Love, Schizophrenia and All,” The New York Times (October 7, 2006), nytimes.com. Accessed June 17, 2009.
Torrey, EF. Nowhere to Go: The Tragic Odyssey of the Homeless Mentally Ill (New York: Harper and Row, 1988).
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Diedrich, L. Being the Shadow: Witnessing Schizophrenia. J Med Humanit 31, 91–109 (2010). https://doi.org/10.1007/s10912-010-9109-1
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DOI: https://doi.org/10.1007/s10912-010-9109-1